Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study

Li, Yanli; Sun, Wenwu; Guo, Yanan; Chen, Liangkai; Zhang, Lijuan; Zhao, Suisheng; Ding, Long; Yu, Li

doi:10.1080/09537104.2020.1754383

Cited by 292 publications

(327 citation statements)

References 23 publications

(25 reference statements)

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“…The search process identi ed 1832 publications in the initial search. After screening, we included 36 studies in the systematic review , of which 27 were included in the meta-analysis [3,5,6,9,[11][12][13]15,16,[19][20][21][22][23][24][25][26][28][29][30][31][32][33][34][35][36]38]. The literature selection process is shown in Figure 1.…”

Section: Literature Searchmentioning

confidence: 99%

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

Shi

Wang

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) is associated with a high mortality rate, especially in patients with severe illness. We conducted a systematic review and meta-analysis to assess the potential predictors of mortality in patients with COVID-19.Methods: PubMed, EMBASE, the Cochrane Library, and three electronic Chinese databases were searched from December 1, 2019, to April 29, 2020. Eligible studies reporting potential predictors of mortality in patients with COVID-19 were identified. Unadjusted prognostic effect estimates were pooled using the random-effects model if data from at least two studies were available. Adjusted prognostic eﬀect estimates were presented by qualitative analysis.Results: Thirty-six observational studies were identified, of which 27 were included in the meta-analysis. A total of 106 potential risk factors were tested and the following important predictors were associated with mortality: advanced age, male sex, current smoking status, preexisting comorbidities (especially chronic kidney, respiratory, and cardio-cerebrovascular diseases), symptoms of dyspnea, complications during hospitalization, corticosteroid use and a severe condition. Additionally, a series of abnormal laboratory biomarkers of hematologic parameters, hepatorenal function, inflammation, coagulation, and cardiovascular injury were also associated with fatal outcome.Conclusion: We identified predictors of mortality in patients with COVID-19. These findings could help healthcare providers take appropriate measures and improve clinical outcomes in such patients.

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Section: Literature Searchmentioning

confidence: 99%

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

Shi

Wang

et al. 2020

Preprint

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“…The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that has swept the globe in 2019 and 2020 causes Coronavirus Disease 2019 (COVID-19), a predominantly respiratory illness with 11.5–13% mortality among hospitalized patients [ 1 , 2 , 3 ]. 80% of patients infected by SARS-CoV-2 may be asymptomatic or only mildly symptomatic, but around 10% develop severe respiratory symptoms that evolve to acute respiratory distress syndrome (ARDS) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 Disease on Platelets and Coagulation

2020

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Coronavirus disease 2019 (COVID-19) causes a spectrum of disease; some patients develop a severe proinflammatory state which can be associated with a unique coagulopathy and procoagulant endothelial phenotype. Initially, COVID-19 infection produces a prominent elevation of fibrinogen and D-dimer/fibrin(ogen) degradation products. This is associated with systemic hypercoagulability and frequent venous thromboembolic events. The degree of D-dimer elevation positively correlates with mortality in COVID-19 patients. COVID-19 also leads to arterial thrombotic events (including strokes and ischemic limbs) as well as microvascular thrombotic disorders (as frequently documented at autopsy in the pulmonary vascular beds). COVID-19 patients often have mild thrombocytopenia and appear to have increased platelet consumption, together with a corresponding increase in platelet production. Disseminated intravascular coagulopathy (DIC) and severe bleeding events are uncommon in COVID-19 patients. Here, we review the current state of knowledge of COVID-19 and hemostasis.

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“…Some researches reported the similar result in the association between the single organ injury and survival rate separately [29][30][31][32]. However, some organs injury often co-exist in severe COVID patients.…”

Section: Discussionmentioning

confidence: 72%

Early Risk Factors for Extrapulmonary Organ Injury in Adult COVID-19 Patients

Huang

Jin

et al. 2020

Preprint

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Objective COVID-19 is becoming a global pandemic and often develops extrapulmonary organ injury. However, the risk factors for extrapulmonary organ injury are still unclear. We aim to explore the risk factors for extrapulmonary organ injury for COVID-19 and the association between extrapulmonary organ injury and the prognosis of COVID-19 patients. Methods This is a single-center, retrospective, observational study and total 349 confirmed COVID-19 patients admitted to Tongji Hospital from January 25 to February 25, 2020 were enrolled. We collected demographic, clinical, laboratory and treatment data from electronic medical records. Potential risk factors for extrapulmonary organ injury of COVID-19 patients were analyzed by a multivariable binary logistic model, and multivariable COX proportional hazard regression model was used for survival analysis in the patients with extrapulmonary organ injury. Results Average age of the included patients was 61.73±14.64 years. In the final logistic model, variables including aged 60 or older (OR 1.826, 95% CI 1.060-3.142), ARDS (OR 2.748, 95% CI 1.051-7.185), lymphocytes count lower than 1.1 ×109/L (OR 0.478, 95% CI 0.240-0.949), level of IL-6 greater than 7 pg/ml (OR 1.664, 95% CI 1.005-2.751) and D-Dimer greater than 0.5 μg/ml (OR 2.190, 95% CI 1.176-4.084) were significantly associated with the extrapulmonary organ injury. Kaplan-Meier curve and log-rank test showed that the probabilities of survival for patients with extrapulmonary organ injury were significantly lower than those without extrapulmonary organ injury.between Multivariate COX proportional hazards model showed that only myocardial injury (P=0.000, HR: 5.068, 95% CI: 2.728-9.417) and circulatory system injury (P=0.000, HR: 4.076, 95% CI: 2.216-7.498) were the independent factors associated with COVID-19 patients’ poor prognosis. Conclusion Older age, lymphocytopenia, high level of D-Dimer and IL-6 and the severity of lung injury were the high-risk factors of extrapulmonary organ injury in COVID-19 patients. Myocardial and circulatory system injury were the most important risk factors related to poor outcomes of COVID-19 patients. It may help clinicians to identify extrapulmonary organ injury early and provide relevant management strategy.

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Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study

Cited by 292 publications

References 23 publications

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

Predictors of mortality in patients with coronavirus disease 2019: a systematic review and meta-analysis

The Impact of COVID-19 Disease on Platelets and Coagulation

Early Risk Factors for Extrapulmonary Organ Injury in Adult COVID-19 Patients

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